Broeckel, Philip George

Broeckel, Philip George is an sole proprietor health care provider with primary practice located at 9888 Genesee Ave , La Jolla CA 92037-1205. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Broeckel, Philip George can be contacted via phone (858) 626-6151.

Contact Information

Primary practice address
9888 Genesee Ave La Jolla CA 92037-1205
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X G37332 California

Profile Details

NPI number 1629146600
LBN Legal business name Broeckel, Philip George
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2006
Last updated Oct 19th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629146600 NPPES
California Other MEDICAL LICENSE G37332

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